LPN to BSN Nursing Application
Please read through all questions below first before beginning the application process. You must sign at the bottom of this page to ensure submission of your completed application.
Start Term
*
Please Select
Fall 2027
Name
*
First Name
Last Name
Preferred First Name
Legal sex
*
Please Select
Male
Female
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Social Security Number
*
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Home Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
As a higher education institution receiving federal Title IV funding, we are required to give applicants the opportunity to report their race and ethnicity. Providing this information is entirely voluntary. Your response—or decision not to respond—will not impact your admission decision and will be used solely for federal statistical compliance and institutional research.
Are you Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)
Yes, Hispanic or Latino
No, not Hispanic or Latino
What is your race? (Select one or more races that apply to you)
American Indian or Alaska Native (A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.)
Asian (A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent (e.g., Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam).
Black or African American (A person having origins in any of the Black racial groups of Africa.)
Native Hawaiian or Other Pacific Islander (A person having origins in any of the originalpeoples of Hawaii, Guam, Samoa, or other Pacific Islands.)
White (A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.)
Have you ever been: Convicted of or plead to a misdemeanor and/or felony, suspended or expelled by a prior institution/school, or been disciplined through or named a respondent in a Title IX or sexual misconduct process?
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Yes
No
Education
LPN-BSN Program Type
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Part-Time
Full-Time
LPN School
*
Year Graduated
*
LPN License #
*
Licensing State
*
Have you completed college credit?
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Yes
No
Have you previously attended a college or university?
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Yes
No
If yes, list the college(s)/university(ies) attended
Letter of Recommendation
2 letters of recommendation are required for admission
Letter of Recommendation
*
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Letter of Recommendation
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Transcripts
Please upload transcript of all completed LPN courses completed
*
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Please upload all completed collegiate coursework for consideration. These are any college courses you may have taken separate of your LPN program
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Please upload proof of license verification
*
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Signature
*
Submit
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